Congestive heart failure (CHF) has become the number one reason for hospitalization in the United States. Women are more commonly hospitalized than men for this condition (in 1998, 540,000 women compared with 438,000 men). Diastolic dysfunction is becoming increasingly recognized as a significant factor in the etiology of CHF. Of the total affected population, 70% of patients with diastolic heart failure are female, with a majority being elderly. There is currently no effective pharmacological therapy for the treatment of diastolic function. With the cross-sectional studies and limited training trials (men only) supporting the hypothesis that exercise may improve diastolic function, there is a need for more properly controlled and adequately powered studies examining the effect of exercise training on diastolic function, particularly in populations at high risk for CHF such as sedentary, postmenopausal women with elevated blood pressure. The proposed study is a prospective ancillary study to the NHLBI Dose-Response to Exercise in Women (DREW) study. DREW started in January 2001. In DREW, 450 overweight, sedentary, postmenopausal women will be randomly assigned either to a non-exercise control group or to 1 of 3 exercise groups at 50, 100, and 150%, respectively, of the consensus public health recommendation for weekly physical activity (exercise). Exercising women perform supervised exercise for 6 months at our center. The DREW study will evaluate the dose-response of exercise training in regard to changes in multiple cardiac risk factors. We propose to measure diastolic function in a sub-set of this study population to examine the dose-response relation between changes in physical activity (and fitness) and diastolic function. We anticipate performing baseline and follow-up measurement of diastolic function in a total of 215 women, which will include approximately 50 women per exercise group. This study represents a unique, timely, and efficient opportunity to quickly explore the relation between diastolic function and physical activity in postmenopausal women. [unreadable] [unreadable]